The Importance of An Alternative Approach to Measuring Quality in a Volume to Value World: A Case Study of Diabetes Care

Authors

Betty J. Burston, University of Nevada, Las VegasFollow
L. J. Coombs
D. Liu

Editors

Betty G. Burston (Ed.)

Document Type

Article

Publication Date

12-10-2017

Publication Title

BMJ Open Quality

Volume

6

First page number:

1

Last page number:

7

Abstract

Background: To develop a statistical tool that allows practitioners and/or their practice managers to easily select the relevant range in which volume and value are maximised. Methods: Data for the study were based on 55 primary care practices that participated in the Colorado Improving Performance in Practice programme in 2014. We used two composite variables including the volume of processes of care variables listed in Diabetes Practice Guidelines and value (quality) as measured by changes in the intermediate outcomes. We assessed volume/value trade-offs using a multilevel model with a time-varying covariate partitioned into a between-practice and within-practice effect. Results: The study revealed a strong linear relationship between volume and value (P< 0.0001). Specifically, practices with an above-average volume of care as measured by their process of care scores also had above-average quality outcomes (expected value 57; average volume 49.48) as quantified by their intermediate outcome scores. Additionally, in those months when practices provided a volume of care that exceeded their average process of care score, further improvements occurred in quality as measured by intermediate outcome scores (P< 0.0001). Conclusion: Such findings suggest an inherent linkage between volume of care and quality. This statistical approach, if provided as an app containing an easy-to-use statistical calculator, will allow practice managers and clinicians to systematically identify volume/quality trade-offs, thereby reducing undertreatment and/or overtreatment among patients with chronicities.

File Format

PDF

File Size

237 KB

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Repository Citation

Burston, B. J., Coombs, L. J., Liu, D. (2017). The Importance of An Alternative Approach to Measuring Quality in a Volume to Value World: A Case Study of Diabetes Care. In Betty G. Burston (Ed.), BMJ Open Quality, 6 1-7.
http://dx.doi.org/10.1136/bmjoq-2017-000216